Management of chronic constipation in general practice (original) (raw)

Abstract

Background

Chronic constipation is often diagnosed and treated by general practitioners (GPs). The aim of the study was to evaluate the management of constipation by a cohort of Italian GPs.

Methods

Over the course of 1 month, 41 GPs recorded tests and therapies suggested to patients complaining of chronic constipation. They were classified according to the Rome III criteria as constipated irritable bowel syndrome (C-IBS), functional constipation (FC), or “self-perceived constipation” (SPC) (not consistent with the Rome criteria).

Results

The most frequently prescribed tests for the 229 patients (147 FC, 50 C-IBS, 32 SPC) were routine blood tests (59.3 %), abdominal ultrasounds (37.2 %), thyroid function (36.7 %), fecal occult blood tests (36.7 %), and tumor markers (35 %). Patient sex and age, GP age, and whether the diagnosis was new influenced the GP’s request, but FC, C-IBS, or SPC status did not. Dietary suggestions (81.9 %), fiber supplements (59.7 %), reassurance (50.9 %), and laxatives (30.5 %) were the most frequently prescribed treatments. Antispasmodics were more frequently suggested for C-IBS patients; dietary suggestions, fiber, and enemas were more frequently prescribed in SPC patients. Patient and GP age and whether the diagnosis was new influenced the GP’s choice of treatment.

Conclusions

The Rome III criteria do not influence diagnostic strategies and only slightly influence therapeutic strategies of GPs. Other factors (age, gender, new or old diagnosis) have more influence on GPs choice of investigations and treatment.

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Acknowledgments

We wish to thank the following general practitioners who participated in this study: Adriano Amerighi, Pier Luigi Aveni Tramazza, Massimo Baldacci, Alberto Beati, Marco Benvenuti, Enrico Biondi, Rita Buti, Stefano Cardamone, Massimo Carlesi, Alessandro Ceccotti, Geraldo Ciacchini, Giorgio Ciampalini, Alessandro Del Punta, Franchino Franchi, Paola Gadducci, Luca Gafforio, Vanni Galloni, Marco Gasperini, Nicola Gerbi, Gisella Giannessi, Pellegrino Giorgi, Sandra Giustarini, Luciano Giusti, Nedda Grassi, Massimo Guidi, Francesco Marchetti, Gabriella Marchitiello, Maurizio Martinelli, Giovanni Merlini, Andrea Mori, Roberto Neri, Paolo Paolicchi, Carlo Pellegrini, Federica Pietroni, Luca Puccetti, Giacomo Puccini, Margherita Raspolli Galletti, Carmelo Richiusa, Pietro Rivieri, Gianluca Sguazzi, Carlo Topi, and Maurizio Turbati. The authors are grateful to Simona Maltinti, Lucia Giorgetti, Fabrizio Cristiani, and Fabio Michelotti for their valuable help in carrying out the study.

Conflict of interest

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Authors and Affiliations

  1. Gastrointestinal Unit, Department of Gastroenterology, University of Pisa, Via Paradisa No. 2, 56100, Pisa, Italy
    M. Bellini, D. Gambaccini, M. T. Urbano, F. Costa, M. G. Mumolo, A. Ricchiuti, N. De Bortoli & S. Marchi
  2. CNR, Institute of Clinical Physiology, Via Moruzzi No.1, 56124, Pisa, Italy
    S. Salvadori
  3. Porretta Terme, Italy
    C. Tosetti
  4. Pisa, Italy
    P. Monicelli

Authors

  1. M. Bellini
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  2. D. Gambaccini
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  3. S. Salvadori
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  4. C. Tosetti
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  5. M. T. Urbano
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  6. F. Costa
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  7. P. Monicelli
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  8. M. G. Mumolo
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  9. A. Ricchiuti
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  10. N. De Bortoli
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  11. S. Marchi
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Corresponding author

Correspondence toM. Bellini.

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Bellini, M., Gambaccini, D., Salvadori, S. et al. Management of chronic constipation in general practice.Tech Coloproctol 18, 543–549 (2014). https://doi.org/10.1007/s10151-013-1093-9

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